Upper blepharoplasty
Hooded, heavy upper lids Skin that folds over the crease, hides your eyeshadow, rests on your lashes, or cuts into what you can see above you.
← All comparisons
Dermapedia / CompareProcedures
Upper vs Lower Blepharoplasty
Upper blepharoplasty treats a heavy, hooded upper lid. The surgeon removes a strip of loose skin, and sometimes a little fat, from above the eye. Lower blepharoplasty treats bags and puffiness under the eye. It moves or removes the fat pads that push forward, and sometimes tightens the lid. These are two different operations on two different problems, and the lower one is the harder of the two to get right.
At a glance
| The difference | Upper blepharoplasty | Lower Blepharoplasty |
|---|---|---|
| What the surgeon does | Removes a strip of skin | Moves or removes fat |
| What it is like on the day | Awake, local anaesthetic, under an hour | Local, sometimes sedation |
| Recovery | About one to two weeks | About two to three weeks |
| Cost and insurance | Sometimes covered | Almost always cosmetic |
Lower Blepharoplasty
Side by side
The differences that matter
The problem it fixes
Upper blepharoplasty
Hooded, heavy upper lids
Skin that folds over the crease, hides your eyeshadow, rests on your lashes, or cuts into what you can see above you.
Lower Blepharoplasty
Under-eye bags and puffiness
Pads of fat that bulge forward and cast a shadow, often worse in the morning.
What the surgeon does
Upper blepharoplasty
Removes a strip of skin
The fold is marked while you sit up, then trimmed. A little muscle or fat may go with it. The edges are stitched inside the natural crease.
Lower Blepharoplasty
Moves or removes fat
Fat is trimmed, or spread down into the hollow below to smooth the step. Loose skin may be tightened, and the lid may be anchored at its outer corner.
Where the scar is
Upper blepharoplasty
In the eyelid crease
It fades to a fine line most people cannot find.
Lower Blepharoplasty
Often no visible scar
When only fat is being handled, the cut is made inside the lid. If skin is being removed, the cut sits just under the lash line.
What it is like on the day
Upper blepharoplasty
Awake, local anaesthetic, under an hour
Usually done in a clinic room. You feel pressure, not pain.
Lower Blepharoplasty
Local, sometimes sedation
Longer than the upper, and more often done with sedation.
Recovery
Upper blepharoplasty
About one to two weeks
Bruising and swelling peak in the first few days. Stitches come out around day five or six. Most people are back at work inside a week.
Lower Blepharoplasty
About two to three weeks
Slower and blotchier. Bruising can spread down the cheek. Swelling under the eye takes longer to settle than most people expect.
What it will not do
Upper blepharoplasty
It will not lift your brow
If the brow itself has dropped, removing lid skin can make the eye look tighter but leave the heaviness. A brow lift is the different operation.
Lower Blepharoplasty
It will not lighten dark circles
If the darkness is pigment in the skin rather than shadow from a bulge, surgery changes very little.
Main risk to know
Upper blepharoplasty
Trouble closing the eye fully
If too much skin comes off, the lid may not shut completely, which leaves the eye dry and gritty. Usually temporary. Slight unevenness between the two sides is the more common complaint.
Lower Blepharoplasty
The lid pulling away from the eye
Called ectropion. The lower lid sags outward or the white below the iris shows more, changing the shape of the eye. It is the reason lower lid surgery is the riskier of the two and why surgeon choice matters most here.
Cost and insurance
Upper blepharoplasty
Sometimes covered
When the hood blocks your upper field of vision, insurance may pay. It usually needs a vision test and photographs first.
Lower Blepharoplasty
Almost always cosmetic
Bags rarely affect sight, so this is normally paid for privately.
The at-home or drugstore version
Upper blepharoplasty
There is none
Creams cannot remove skin. Eyelid tape and glue hide a hood for an evening and do nothing lasting.
Lower Blepharoplasty
Only for the mild end
Caffeine gels and cold compresses shift fluid, so morning puffiness looks better for an hour or two. They do nothing to a fat pad. Under-eye filler is the real non-surgical option, and it is a different tool for a different problem.
Who each suits
Upper blepharoplasty
- Best for — Hooded lids, tired-looking eyes, a lost crease, or a blocked view.
- The trade — A visible healing week for a change that lasts many years.
Lower Blepharoplasty
- Best for — True fat bags that stay puffy all day.
- The trade — Longer recovery and a smaller margin for error.
Before you book
More photographs
Lower Blepharoplasty
Common questions
Questions Patients Ask
Do I need upper or lower eyelid surgery?
Upper if the skin above your eye is hooded, heavy, or blocking your view. Lower if the problem is bags and puffiness underneath.
Which one is riskier?
The lower. The lower lid can pull away from the eye and change its shape, so experience matters more for that operation.
Will insurance pay for it?
Sometimes for the upper lids, if the hood blocks your upper field of vision. That usually needs a vision test and photographs. Lower lid surgery is almost always cosmetic.
How long is the recovery?
Roughly one to two weeks for the upper lids and two to three for the lower. Swelling under the eye takes longer to settle than most people expect.
Will eyelid surgery fix my dark circles?
Only if they are shadows cast by a bulge. Brown pigment and thin skin do not respond to surgery, and hollows are usually better treated with filler.
Can I have both at the same time?
Yes, and it is a common combination. It means one recovery instead of two, but more bruising and both sets of risks at once.